Utility of digitally supported surgical competency assessments in a work-based setting: a systematic review of the literature.

Background: Adequate training and assessment of competency in surgical trainees are important in minimizing adverse events and achieving good patient outcomes. The purpose was to investigate the current literature on digitally supported methods of facilitating work-based competency assessment of surgical trainees.

Methods: Two concurrent literature searches were performed by two independent researchers using three databases: MEDLINE, Embase and Education Resources Information Center. Eligible studies reported on digitally supported tools for assessing surgical competency in a work-based setting for interns, residents or trainees of a post-graduate surgical programme. Studies focusing primarily on training courses, simulations or other tools for assessing surgical skills in a setting outside of work were excluded. Articles published as abstracts only, articles not published in English and review articles that did not contain original data were excluded.

Results: A total of 11 eligible studies were included, with six of these implementing smartphone application-based programmes, and five utilizing web-based programmes. Five studies implemented the 'System for Improving and Measuring Procedural Learning' smartphone application. Studies were based predominantly on general surgery residents, and were limited to the North American context. There was significant variability between studies regarding methodology, including the scoring system used to assess competency.

Conclusion: This review confirms that digitally supported competency assessment of surgical trainees in a work-based setting is both feasible and effective. Digital platforms allow evaluations to be performed in a timely fashion without significant disturbance to workflow.